New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XXI - OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
Part 830 - Acupuncture Therapy In Alcoholism And Substance Abuse Treatment Facilities
Section 830.5 - Telehealth

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 830.5

Current through Register Vol. 46, No. 12, March 20, 2024

(a) Limitations.

(1) Services delivered via Telehealth, as defined in this Part, may be authorized by the Office for the delivery of addiction services provided by practitioners employed by, or pursuant to a contract or Memorandum of Understanding (MOU) with a program certified by the Office. All services may be delivered via telehealth unless otherwise specified by the Office in the Telehealth Standards for OASAS Designated Providers, as incorporated in this Title (hereafter the Telehealth Standards), posted on the Office website.

(2) The Office supports the use of telehealth as an appropriate component of the delivery of addiction services to the extent that it is in the best interests of the person receiving services; is performed in compliance with applicable federal and state laws and regulations, the provisions of this Part, and the Telehealth Standards in order to address legitimate concerns about privacy, security, patient safety, and interoperability; and is delivered by appropriate staff working within their scope of practice.

(3) Services may be delivered via telehealth by a practitioner from a site distant from the location of the patient, provided both practitioner and patient are located in sites approved by the Office pursuant to the policies and procedures submitted by a certified program in an application for a telehealth designation.

(4) Telehealth does not include an electronic mail message, a text message or facsimile transmission between a program and a patient or a consultation between two practitioners, although these activities may support the delivery of services via telehealth.

(5) An Office certified program must obtain prior written authorization from the Office pursuant to this section before implementing telehealth service; services shall be limited to those authorized and approved by the Office.

(b) Designation.

(1) Requests for designation to provide telehealth services shall be in the form of policies and procedures and an attestation, found in the Telehealth Standards posted on the agency website, and submitted by a certified provider to the Office Bureau of Certification and the Regional Office serving the area in which the applicant site is located. Such Regional Office may make an on-site visit to either or both linked sites prior to final approval and designation which will be issued by the Bureau of Certification.

(2) Office approval and operating certificate designation will be based on review of the policies and procedures and attestation addressing the following criteria, including but not limited to:
(i) service delivery via telehealth must be conducted via telecommunication systems employing acceptable authentication and identification procedures by both the sender and the receiver; applicant must document a relationship with a credible technology service provider;

(ii) delivery of services via telehealth meet federal and state confidentiality requirements including, but not limited to, 42 C.F. R. Part 2, and 45 C.F.R. Parts 160 and 164 (HIPAA Security Rules);

(iii) confidentiality requirements applicable to written medical records shall apply to services delivered via telehealth including the actual transmission of the service, any recordings made during the transmission, and any other electronic records;

(iv) spaces occupied by the patient and the practitioner must both meet minimum privacy standards consistent with patient-practitioner interaction and confidentiality;

(v) culturally competent and affirming interpretation and translation services must be provided when the patient and practitioner do not speak the same language;

(vi) a written procedure detailing the availability of in-person services by medical staff in an emergency situation;

(vii) written procedures for a contingency plan in the event of a transmission failure or other technical difficulties which may render the service undeliverable;

(viii) when applicable, a written and executed contract or MOU between an applicant provider and an individual practitioner or a corporate entity encompassing multiple practitioners regarding the above criteria and including billing, payment, record sharing, background checks, and any other relevant details necessary for implementation;

(ix) a practitioner must be licensed or credentialed to practice in New York State and be in good standing with the appropriate licensing or credentialing authority and be physically located in the USA when providing services via telehealth;

(x) the provision of buprenorphine prescribing and monitoring via telehealth must comply with applicable state and federal laws and regulations; additional guidance may be found in the Telehealth Standards.

(c) Implementation.

(1) The patient shall be seeking services from a program certified by the Office.
(i) The practitioner shall prepare appropriate documentation of the service and, if appropriate, securely forward said documentation to the designated program as a condition of reimbursement;

(ii) If services delivered via telehealth are a regular part of an admitted patient's treatment/recovery plan, the practitioner must coordinate with the responsible professional at the patient's designated program to prepare and/or update the treatment/recovery plan in accordance with this Title to permit the patient's program to be reimbursed for continuing services;

(iii) The patient must be provided basic information about telehealth including alternatives, possible delays in service, possible need to travel to an approved originating site to receive services, risks associated with not having the services provided; the patient must acknowledge in writing having received such information;

(iv) The patient may refuse to receive services via telehealth.

(v) Patients and prospective patients must be evaluated to determine if service delivery via telehealth is appropriate; additional evaluations may be required for medication for addiction treatment using controlled substances.

(2) Service delivery via telehealth must be included in a provider's quality review process.

(3) The distant site practitioner must directly render the service delivered via telehealth;

(4) If the distant site is a hospital, the practitioner must be credentialed and privileged by such hospital, consistent with applicable accreditation standards.

(5) Telehealth sessions shall not be recorded without the patient's consent, which shall be documented in the clinical record.

(6) Unless otherwise required, persons receiving services via telehealth may be accompanied by a staff member during the session or may be alone. If the initial evaluation or a subsequent treatment/recovery plan recommends that the patient be accompanied during telehealth sessions, the patient must be accompanied for the session to be reimbursed.

(d) Medicaid Reimbursement.

(1) For purposes of billing for Medicaid reimbursement, both the practitioner and/or facility employing the practitioner, and the designated program must be Medicaid enrolled

(2) For purposes of this subdivision, services delivered via telehealth shall be considered face-to-face contacts.

(3) To be eligible for Medicaid reimbursement, services delivered via telehealth must meet all requirements applicable to service delivery in accordance with Part 841 and the Part pursuant to which the designated program operating certificate is issued and must exercise the same standard of care as services delivered on-site or in-community.

(4) Services delivered via telehealth will be reimbursed at the same rates for identical procedures provided by practitioners in person and delivered on-site or in-community unless otherwise specified by the Office.

(5) The designated program is the primary billing entity; reimbursement for practitioners at a distant site must be pursuant to a contract or MOU. Delivery of services via telehealth are covered when medically necessary and under the following circumstances:
(i) the patient is located at an originating site and is seeking a service(s) from a certified program;

(ii) the practitioner is employed by or contracted with a program certified by the Office;

(iii) the patient or significant other is present during the telehealth session;

(iv) the request for a telehealth session and the rationale for the request are documented in the patient's case record;

(v) the patient case record includes documentation that the telehealth session occurred and the results and findings were communicated to the designated provider.

(6) If the person receiving services or a significant other are not present during the telehealth session, the service is not eligible for third party reimbursement and any incurred costs remain the responsibility of the designated provider.

(7) Services delivered via telehealth may only be delivered via technological means approved by the federal Center for Medicaid and Medicare Services (CMS), provided such means are compliant with federal confidentiality requirements.

(8) If all or part of a service delivered via telehealth is undeliverable due to a failure of transmission or other technical difficulty, reimbursement shall not be provided.

(e) Contracts or Memorandum of Understanding (MOU) for the Provision of Telepractice services.

(1) Prior approval of the Office is not required before entering into such contracts or MOU; however, notice of such contracts or agreements must be provided by the OASAS certified provider to the Office Bureau of Certification within thirty (30) days after execution of such contract or MOU or as part of the application for designation.

(2) The designated OASAS program is the default billing entity. Reimbursement of practitioners for services delivered via telehealth shall be pursuant to such contract or MOU; services are not separately billable by the practitioner unless agreed to in writing in advance of any service delivery.

(3) Designated programs or approved practitioners shall not engage in any service delivery via telehealth not otherwise authorized by the Office.

(4) Practitioners under contract or MOU with a certified and designated program must comply with the provisions of Part 805 of this Title related to criminal history information reviews or provide documentation that such security checks have been conducted and satisfied.

(5) Designated programs shall notify the Office Bureau of Certification of any change in practitioners pursuant to a contract or MOU and compliance with provisions of Part 805 of this Title.

(f) Telehealth Standards. The Office shall post standards on its public website to assist in compliance with the provisions of this Part and in achieving treatment goals through the provision of service delivery via telehealth. Such standards shall include, but not be limited to:

(1) Technology guidelines, including:
(i) The minimum technology thresholds (i.e., equipment, bandwidth, videoconferencing software, network specifications, carrier selection, hub/bridge, and security specifications), which shall be updated as new technology is approved; and

(ii) The form or format regarding the technology and communications to be used.

(2) Clinical standards, including but not limited to, the prescribing of medication for addiction treatment (MAT), including controlled substances, via telehealth.

(g) Policies and procedures. A program designated to deliver services via telehealth must have written policies and procedures submitted by the program for designation approval, and the applicable requirements of this Part.

(h) Medication for Addiction Treatment. Initiation and prescribing of medications for addiction treatment must be done in accordance any and all applicable federal rules and regulations; guidance may be found in the Telehealth Standards posted on the agency website.

Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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